Should Doctors Recommend a Gluten-Free Diet for All Elderly Celiac Patients?

As an "old celiac," diagnosed at age 69, and basically asymptomatic, I can not imagine not being given the option of education about, and treatment with, the gluten free diet.  My grandmother died in 1949 of "wasting."  She was younger than I am now, and in hindsight, she probably had celiacs.

I total agree with Scott Adams. Thank you for speaking out. 

I think it should be recommended but there will be those newly diagnosed elderly celiac patients who will choose to ignore the recommendations for various reasons. Among them is the learning curve involved, strain on limited budgets, and social isolation. Social isolation is going to be a big one. And I'm not sure we have any firm data at this point to say that untreated celiac disease shortens life spans. So you take someone has already attained to the 80+ age and they think, "It's not worth the hassle, expense and the changes to my social life. I'm just going to keep doing what I've been doing for the time I have left." This will be especially true for those whose symptoms are less dramatic. I have an uncle who is about 90 yr. old who was dx'd with celiac disease maybe 10-12 years ago and this was his perspective. And I get that.

I think a doctor's job is to diagnose, explain the best treatment, and then explain what could happen if the patient doesn't follow that treatment. It's up to the patient to decide what treatment to follow, but all of the above must occur first before the patient can make an informed decision. To me this sounds almost like doctors might make the decision not to tell older people that they have celiac disease, which is just wrong.

Agreed.

When I was diagnosed at 49, my father was 74.  His dr did not test him because "he had no symptoms".  When Dad developed recurring diarrhea, the dr said he was lactose intolerant, without testing for celiac.  It would have been easy to switch to a gluten-free diet because all he would have to do would be to eat my gluten-free cereal, bread, etc.  His dinners were already gluten-free because he ate what I ate.  (Easier than giving up milk, cheese and ice cream.)  I got the strong impression from the dr and the PA in that small medical group that they just didn't take celiac seriously.  

I've often wondered how many elderly in nursing homes are there because of undiagnosed celiac disease.  Does anyone know of such a study?  

I've never seen such a study, but your question is certainly worthy of a study.

I have genetic celiac disease and diabetes. I was horrified that gluten-free products have no nutritional value. In my situation is that empty nutritional value and high carbohydrate content is almost impossible to deal with. I have an Gastrologist and Endocrinologist who seem useless. I was diagnosed at 67 years old. I understand why this is happening?

Just so you know, there are many great gluten-free products that are highly nutritious. Of course there are also many that are not, and are full of empty carbs and refined flours that don't include much else except starches. Whole foods prepared at home are best, and finding high quality products high in fiber, nutrients, etc., is important.

On 4/6/2021 at 10:58 AM, Oldturdle said:

As an "old celiac," diagnosed at age 69, and basically asymptomatic, I can not imagine not being given the option of education about, and treatment with, the gluten free diet.  My grandmother died in 1949 of "wasting."  She was younger than I am now, and in hindsight, she probably had celiacs.

My grandmother died at 99.  I don't know if she ever had active celiac disease, but I do know she had a celiac gene because my mother ended up with two copies, and therefore, one had to have come from her mother.  My grandmother had very bad arthritis by the time she was in her 80's.  I will never know if that was connected to celiac disease, and I don't know if she had other symptoms she wouldn't have talked about, and obviously, the connections to all these other conditions were totally unknown in the 1980's and 90's.   (She died in 1994).  I can only speculate, but I'll bet she had other things going on as well.  My mother, on the other hand, having two celiac genes, got suddenly very sick from celiac when she was about 46.  She had the classically known symptoms (at that time) of the whole digestive/villous atrophy/highly sensitive type symptoms.  Even with cross contamination she would be violently ill.  Her active celiac disease was apparently triggered (since she had the gene/s) after surgery.

I was just diagnosed less than a year ago at age 71. It all began with blood clots that traveled to my lungs. My doctor at the time did not know why the blood clots happened and I was insistent on trying to find out why. My other symptoms were abdominal swelling, fatigue, body aches and headaches. Among many other tests, I had the Celiac Panel test and was a weak positive (6) on the (tTG) Iga. Everything else was negative. I could not have the biopsy because I am on blood thinners for the clots. I do not have the results back on the genetic test yet. As to the article, I started on the gluten free diet immediately because I wanted to feel better. After 3 months I was still having symptoms although somewhat better, so I began the AIP diet and I could really tell the difference in my energy and digestion. I am completely off the acid reflux medication after 7 years. Although the diet is “burdensome”, I would rather live the rest of my life, however long that may be, productive and healthy. It definitely is a choice people should be given.